R Reiter1, S Brosch. 1. Sektion für Phoniatrie und Pädaudiologie der HNO Univ.-Klinik Ulm. rudolf.reiter@uniklinik-ulm.de
Abstract
BACKGROUND: Chronic laryngitis may be a predisposing factor for laryngeal carcinoma. METHOD: 100 consecutive chronic laryngitis patients were assessed for associated factors for this disease. Voice assessment was undertaken, including objective measurement, subjective assessment of sound and a self-assessment by questionnaire--the so-called Voice Handicap Index (VHI). When laryngostroboscopy of the vocal cords was suspicious, then microlaryngoscopy with biopsy and histological examination was undertaken. RESULTS: The main associated factors were found to be nicotine abuse (50 patients), gastro-esophageal/laryngo-esophageal reflux (35 patients) and inhaled corticosteroid therapy (25 patients). Subjectively, all patients considered their voices to be relatively healthy (VHI less than 15). Objective voice parameters and subjectively listening were of no prognostic significance. Indirect microscopic examination could diagnose chronic laryngitis in 31 of cases, rising to 69 when leucoplakia was present. In 6 patients the mucosal wave was found stroboscopically to be abnormal. Additionally these patients underwent direct laryngoscopy and biopsy. On histological examination one of them had a high grade dysplasia and two of them had a carcinoma in situ. CONCLUSION: Patients with chronic laryngitis or development of vocal cord leucoplakia often abuse nicotine, use inhaled corticosteroids for bronchial asthma or suffer from acid reflux. As many patients with chronic laryngitis/leucoplakia subjectively often do not experience any voice limitations, stroboscopic investigation is useful for the early recognition of malignant change.
BACKGROUND:Chronic laryngitis may be a predisposing factor for laryngeal carcinoma. METHOD: 100 consecutive chronic laryngitispatients were assessed for associated factors for this disease. Voice assessment was undertaken, including objective measurement, subjective assessment of sound and a self-assessment by questionnaire--the so-called Voice Handicap Index (VHI). When laryngostroboscopy of the vocal cords was suspicious, then microlaryngoscopy with biopsy and histological examination was undertaken. RESULTS: The main associated factors were found to be nicotine abuse (50 patients), gastro-esophageal/laryngo-esophageal reflux (35 patients) and inhaled corticosteroid therapy (25 patients). Subjectively, all patients considered their voices to be relatively healthy (VHI less than 15). Objective voice parameters and subjectively listening were of no prognostic significance. Indirect microscopic examination could diagnose chronic laryngitis in 31 of cases, rising to 69 when leucoplakia was present. In 6 patients the mucosal wave was found stroboscopically to be abnormal. Additionally these patients underwent direct laryngoscopy and biopsy. On histological examination one of them had a high grade dysplasia and two of them had a carcinoma in situ. CONCLUSION:Patients with chronic laryngitis or development of vocal cord leucoplakia often abusenicotine, use inhaled corticosteroids for bronchial asthma or suffer from acid reflux. As many patients with chronic laryngitis/leucoplakia subjectively often do not experience any voice limitations, stroboscopic investigation is useful for the early recognition of malignant change.